LaJeana Hall never looked into her future and saw “fitness instructor” as a skill she would attain.

“I was so heavy before, it wasn’t something that I thought I’d ever try,” said Hall, the owner of a tax and accounting business.

But that was 75 pounds ago.

After years of weight struggles, Hall in July 2014 decided to proceed with bariatric surgery at Tucson Medical Center with surgeon Jeffrey Monash.

Not surgery alone

As part of their care, patients learn all about nutrition, they are introduced to fitness activities and they participate in support groups to help them stay on track with their goals.
LaJeana had never tried Pilates before, but it was offered with the program so she decided to try it.

“I really enjoyed it,” she recalled. “It’s not as hard as people think, you can do it with just a yoga mat and it actually worked. I saw results fairly quickly.”

She could feel her muscles lengthening and tightening and she saw some trouble spots get more streamlined.

She liked it so much, in fact, that she started encouraging others to try it. One thing led to another and she decided to become a certified instructor. She completed the program in July to teach basic and plus-sized Pilates and hopes to start teaching soon at her church.

Persistence

Hall is quick to note that her progress took persistence. “I exercise more, including walking and weight training. I eat better and I try to not eat as much sugar. I don’t sit around eating junk food out of boredom – I try to stay busy.”

Hall said she’s glad she made the change. “I sleep better. I feel better. I’m half the person I used to be and it’s important to me that I can work out and not have to stop because I’m out of breath.”
She hopes her progress will inspire others. “I think it helps show people that they can do it too. If you stick to the program that they set for you, you’ll be able to reach your goals too.”

Donn Corder has battled extra pounds for most of her life. So when she decided to fight back, she turned to two tools: Measuring cups and a food scale.

Corder, 59, who has volunteered in pastoral services at TMC for two years, was attending a lunch & learn session for volunteers when she learned about TMC’s weight management program. “I knew I needed to do something,” Corder explained. “My weight was creeping up and no matter what I seemed to do, it wasn’t going away. I also knew I didn’t want surgery and I also didn’t want a ‘system.’ I wanted to eat real food and not something out of a box.”

Corder met with registered dietitian Laurie Ledford, who went over her blood work to determine any risk factors. Corder was borderline on cholesterol and she comes from a long line of family members with diabetes.

Corder was surprised when she left the visit without a food plan to follow. Instead, she left with a food log, instructed to write down everything she ate for a week.

They discovered her servings were too large. The average serving for cereal is one cup. She had been just filling her bowl, and the result was twice that.

“I eat fast, so I didn’t realize how much I was eating. I started measuring and weighing everything,” she said. And she started to be more conscious of what she was eating.

Take cheese – a food Corder is particularly fond of. Ledford asked if she could really taste it in her salad, for example. And the answer was: Not especially. So the two of them agreed: Corder should eat her cheese, but she should have a chunk of it as a snack and really savor it.

Same with ice cream. Come on: Who eats half a cup of ice cream? But now, if Corder has a craving, she buys those individual servings at the grocery store to help her manage the portion size.

She made other little changes. Two percent milk dropped to one percent. She makes her own salad dressing. She makes snack bags of trail mix she’s made herself with just mixed nuts and raisins, since the ones at the store often have additional candy in them. She even put two weeks of snack bags in her carry on luggage when she took a two week trip.

With the help of the program’s physical activity counseling, she also added in more activity, whether it’s walking the hallways at TMC, jumping on the elliptical machine in the living room or walking up stairs instead of taking the elevator.

“It’s worked for me because I don’t feel deprived because I still have my favorite things.”

The only downside? A shopper she is not, and she now needs new clothes.

“You’re not going to be perfect every day, but it’s a question of whether you can make progress overall. It’s made a huge difference for me because I feel better, I sleep better and I have more energy.”

To find out more about TMC’s weight management program please contact TMC Wellness, (520) 324-4163 or Wellness@tmcaz.com

The American Medical Association in 2013 recognized obesity as a disease, and in doing so took critical steps towards supporting those affected to access science-based healthcare.

The misperceptions and stigma surrounding the causes of obesity often negatively affect an individual’s ability to access the care they need. The more than 90 million adult Americans affected by obesity are at increased risk for a variety of health conditions, including type 2 diabetes, high blood pressure, and sleep apnea.

Despite the significant health impacts of obesity, many of us struggle to talk with our primary care provider about our weight and how a science-based approach can help us to achieve a healthy weight.

Tucson Medical Center offers safe and effective weight-loss programs with both surgical and non-surgical options. We know everyone faces unique challenges to achieving a weight-loss goal. Our team of medical professionals can help you choose the path that’s right for you.

Weight-Loss Counseling Program

Our registered dietitians and exercise physiologists will work with you to create a personalized plan you can live with, so you can lose weight and keep it off. The 12-week program includes: • Nutrition, fitness and general wellness assessments • Reliable advice that you can use • Tracking of weight and estimated body composition • Development of personalized nutrition and fitness plans • Strategies to promote long-term weight-loss success

The program is individualized for you and so you can begin at any time. For more details, please contact TMC Wellness, (520) 324-4163 or Wellness@tmcaz.com.

Weight-Loss Surgery from the TMC Bariatric Center of Excellence

At the TMC Bariatric Center, we offer a comprehensive approach to help those who qualify for weight loss surgery. For most people to qualify you must:

Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts

Our program guides you every step of the way on your weight-loss journey, starting with free seminars to discover if a surgical option is right for you; to pre-surgery counseling and evaluations; post-op care that includes nutritional counseling; psychological support; instruction on incorporated exercises into your lifestyle; and discussion groups where you can build relationships with others who have had bariatric surgery at TMC to help you achieve your goals.

The American Society for Metabolic and Bariatric Surgery (ASMBS) Center of Excellence was started in 2004 to advance the safety and efficiency of bariatric and metabolic surgical care. Surgical Review Corporation administers the program on behalf of the ASMBS.
No matter what method you have used to lose weight, sticking to your new good habits and keeping the weight off can be a challenge. Don’t try to tackle it alone, talk to your primary care provider, talk to us, together we can take on the challenge of obesity and its complex nature and help you be a healthier you.

No matter what method you have used to lose weight, sticking to your new good habits and keeping the weight off can be a challenge. Don’t try to tackle it alone, talk to your primary care provider, talk to us, together we can take on the challenge of obesity and its complex nature and help you be a healthier you.

This week is National Obesity Care Week where the goal is to advance an evidence-based understanding of obesity and widespread access to respectful, comprehensive and appropriate care.

Super foods – juice cleansing – metabolism kick starters – core workouts. Weight-loss is very challenging and the dizzying number of diets, fads and exercises can make it even harder. Tucson Medical Center’s Comprehensive Weight-Loss Program offers safe and effective plans that are personalized to meet each patient’s needs.

These days, busy lifestyles are common– stretching schedules for career, family, activities and so much more. With only so many hours in a day, it’s hard to make time for health and easy to put on pounds fast. More than 70 percent of American adults are overweight and we understand that everyone faces unique challenges to achieving a weight loss goal.

TMC Wellness Director Mary Atkinson explains how the TMC Weight-Loss Program is different. “We look at the whole person,” she said. “Registered dietitians and certified exercise-professionals will work with you to create a personalized plan you can live with, so you can lose weight and keep it off.”

Weight-Loss Counseling Program The 12-week program includes three, one-hour initial appointments and eight follow-ups that last about 30 minutes. Periodic assessments help determine what is working best and allow you and your team to make adjustments to keep

Nutrition, fitness and general wellness assessments

Reliable advice that you can use

Tracking of weight and estimated body composition

Development of personalized nutrition and fitness plans

Strategies to promote long-term weight-loss success

Weight-Loss Surgery from the TMC Bariatric Center

The TMC Bariatric Center, a comprehensive center accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, guides you every step of the way on your weight-loss journey:

Pre-surgery counseling and evaluations

Post-op care that includes nutritional counseling

Psychological support

Instruction on incorporating exercises into your lifestyle

Discussion groups – build relationships with others who have had bariatric surgery at TMC

Some services may be covered by insurance.

Weight Management Support Group

No matter what method you have used to lose weight, sticking to your new good habits and keeping the weight off can be a challenge. Don’t try to tackle it alone. Join our monthly support group, led by a certified health coach, to learn new tips and stay motivated.

Drs. Jeff Monash and Scott Welle from Tucson Bariatric, along with the TMC Auxiliary, recently held the first-ever Celebrate Weight Loss Clothing Exchange. The event marked the kick-off to an ongoing bariatric clothing exchange at The Teal Saguaro, TMC Auxiliary’s new resale boutique. Bariatric patients often lose weight so quickly that it can be difficult for them to find clothes to fit every time they drop a size.

Patients who have undergone weight loss surgery at Tucson Bariatric are invited to drop off their too-large, gently used clothing and shoes (maximum five pieces/pairs of shoes please) to either The Teal Saguaro, 5395 E. Erickson Rd., or Tucson Bariatric, 4715 E. Camp Lowell Dr. in the Swan Corporate Center. In return, they will receive a voucher to get the same number of items in their current size.

Tucson Bariatric employee Binda Tatrowith patient Nancy Killian

More than two dozen patients attended the event, and were thrilled to be able to swap their too-big items for things they can wear NOW. “The patients expressed how grateful they were to be able to find fashionable clothes in their current size at The Teal Saguaro. We absolutely accomplished our goal of providing this service to our patients while making it fun for them. Most left with full shopping bags, some exchanged phone numbers, and everyone was thrilled to be there,” said Dr. Monash.

There were giveaways, healthy refreshments, and friendly help. The bariatric clothing exchange is ongoing at The Teal Saguaro for the patients of Drs. Monash and Welle. Vouchers can be redeemed for up to one year. The Teal Saguaro’s clothing selection always includes plus size garments and remains a great community shopping resource for everyone on a weight loss journey.

Special thanks to Jessica Monash for organizing the event, furnishing the refreshments and decorating the shopping bags.

Since 2011, TMC has been a Bariatric Center of Excellence, an accreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Bariatric surgeries performed at TMC are minimally invasive, and some are even done using the da Vinci surgical robot. For more information about TMC’s Bariatric Program, please call De Anna Elliott at (520) 324-3766.

A recent study done at the University of Minnesota and published in the Journal of the American Medical Association suggests bariatric surgery is a more effective way to reduce and even reverse diabetes than medication and lifestyle changes. The findings, which came from one of the most rigorous studies of its kind, could lead to changes in who qualifies for the surgery.

Dr. Scott WelleTMC Bariatric Surgeon

TMC Bariatric Surgeon Dr. Scott Welle said the research corresponds with exactly what he and other bariatric surgeons have said all along – that weight loss surgery is an effective tool for getting diabetes under control and even having it go into remission. “It’s a lot more common for people to come into my office saying they want to get off their diabetes medicine rather than wanting to lose the weight. Losing the weight is just the bonus.” Type 2 diabetes affects more than 20 million Americans. Most of these patients are overweight or obese, and are at a higher risk for heart disease and stroke, among other things. Diabetes that is not controlled properly can damage the kidneys, eyes and blood vessels.

The yearlong study indicated that gastric bypass, the most common bariatric surgery in which the stomach is stapled to create a small pouch and attached to a lower part of the intestines, can effectively treat diabetes in patients who are considered mild to moderately obese. “We’re finding this especially true for patients with a lower BMI, who are about 50 to 70 pounds overweight. Our overall success rate is more effective with this patient population typically because they haven’t been diabetic as long as patients who are morbidly obese,” said Dr. Welle.

To qualify for weight loss surgery outside of a research institution, a patient must have a BMI of at least 35, and a comorbid condition like diabetes, hypertension, or sleep apnea. That magic number, 35, Dr. Welle explained, was recommended from the National Institutes of Health in the early 1990’s. Newer research, which looks at treating people with a lower BMI, may lead to updated recommendations if the surgery is proven to be safe and effective.

“We’re starting to see these patients when they just barely qualify for surgery based on their BMI. They’re coming in when they’re 80 to 100 pounds overweight, for example, wanting to get off their diabetes medication rather than waiting until they’re 300 pounds overweight,” he said.

Even then, Dr. Welle said, he and his team are not quick to operate. “It’s not like diabetic patients come into our office, and we schedule a surgery date.” The amount of time from the consultation to the actual surgery day can range from two to eight months. There is a pre-authorization and pre-screening process. Patients are given a psychological evaluation, and undergo nutritional counseling. The pre-op workup is intense. Plus, by the time a patient even hits his door, they’ve typically put considerable thought into their decision. “Nine times out of ten, someone who presents for bariatric surgery has been thinking about it for at least five years on average,” he said.

Since 2011, TMC has been a Bariatric Center of Excellence, an accreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). All bariatric surgeries performed at TMC are minimally invasive, and some are even done using the da Vinci surgical robot. Dr. Welle said the surgery requires a one-to-two-day hospital stay, and oftentimes patients are off their diabetes medication by the time they are discharged. “Yes, it happens that quickly with metabolic procedures like gastric bypass. A majority of my patients leave the hospital off their diabetes medication.” Most patients resume their normal lifestyle in one to two weeks.

The study did mention an alarming complication rate. About a third of the 60 adults who underwent gastric bypass developed serious problems within a year of the operation, although some cases were not directly linked to the surgery. For more serious complications, including infections, intestinal blockages and bleeding, the rate was six percent.

“If you look at the study, the number of people who had a complication in the surgery group was 22 out of 60. If you look at the non-surgical group, 15 of those 60 people also had a complication. It’s important to realize that no deaths were reported. So when we say bariatric surgery is safe and effective, it truly is. When you see high complication rates like this in a study, you need to really delve in and look at how strict they’re classifying their complications,” Dr. Welle said. Patients in the surgery group ended up using an average of three fewer medications than patients in the non-surgical group. “That’s medications for diabetes, high blood pressure, and high cholesterol. It’s not just diabetes, rather the gamut of the metabolic syndrome that can be treated effectively with bariatric surgery,” Dr. Welle explained.

For more information about TMC’s Bariatric program, please click here.

Various weight loss support programs didn’t work, and the weight piled on even faster during the grief-filled time after her mother died.

Topping out at 385 pounds on a 5’10” frame, the 54-year-old medical transcriptionist at Tucson Medical Center faced many painful moments: needing an extra seat belt when flying, having strangers evaluate what was in her shopping cart, dealing with stares.

The final straw, though, was when she realized she could barely walk from her car in the parking lot to the front door of her apartment without needing oxygen.

Philipp’s story, however, is one of victory, continuing a series that features TMC athletes in a nod to the Olympics season and demonstrates the multitude of ways to embrace an active lifestyle.

Two years ago, Philipp decided she’d had it. After consulting with her doctor, it was determined she would be a good candidate for bariatric surgery, which limits the amount people can eat and reduces the absorption of nutrients.

It wasn’t a simple decision. It also required a major diet overhaul. Carbonation is frowned upon, so soft drinks are a no-no for the woman who used to be able to drink a case of soda in a day. She can no longer tolerate greasy food, yeast bread, peanut butter and pizza, but instead focused on fruits, vegetables and proteins. She has to eat slowly and chew well to aid digestion. She surprised herself by learning to like cauliflower and Brussels sprouts.

But boy, did the weight come off. She was losing 18 pounds a month for the first 5 months. And she’s still losing about three pounds a month. Now at 199 pounds, she’s well on her way to her target goal of 175.

“Talk about a confidence boost,” she said. And the more confidence she gained, the more active she became.

To get in shape for her surgery, she had started walking with a friend around the block. “I got hooked. I could not get enough of it,” she said. “It was amazing how far I could go once I got some of the weight off me.” Every other day, she now walks 4.5 miles.

In March, she took a class to learn how to run. “I was sore and achy at first. Even my eyelashes would hurt,” she said. She started running for one minute and walking for three, working up to running 4 minutes and walking for one. “Pretty soon, you realize you’re running more than you’re walking. And when they talk about runners getting an endorphin rush, I can now say that’s a fact.”

She said she might be slow – running a 13-minute mile – but she’s doing it, and she’s up to 5 miles every other day. She even did the TMC Meet Me Downtown 5k in early June.

She’s off blood pressure medication. She’s no longer borderline diabetic. She’s become more outgoing with strangers.

“This is one of the best things I’ve ever done and I did it for me, and not for anybody else,” she said. “I didn’t want to sit on the sidelines of life anymore. I needed to be a participant.”

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About TMC

Tucson Medical Center, licensed at more than 600 beds, has been Tucson’s locally governed nonprofit regional hospital for more than 70 years.

TMC is Southern Arizona’s leading provider for emergency care and pediatric care (including Tucson’s first Pediatric Emergency Department), with top-notch intensive care units for adults, children and newborns.